Body MR：01 Biliary cystadenoma（带字幕的视频）

CTISUS Teaching Files—— Body MR：01 Biliary cystadenoma 

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[>d]    

[0:00.4]  

This case, you can see that there's a large cystic mass identified in the right lobe of the liver.

[0:05.4]  

It's T2 bright, but notice how it's not homogeneously T2 bright.

[0:09.6]  

It doesn't just look like a simple cyst.

[0:11.3]  

There are multiple septations, some of the sepations are relatively thick. There's a lot of internal complexity.

[0:17.2]  

And when you look at the post-gadolinium images, you’ll realize that you're dealing with actual enhancing nodular soft tissue.

[0:23.4]  

There's a discrete soft tissue component, these septations are enhancing and many of the septations are relatively thick, nodular, and irregular in appearance.

[0:31.7]  

Now this is certainly an entity that you don't want to read just as a simple cyst or complicated cyst. 

[0:37.4]  

And you have to raise the possibility that this patient has a primary cystic neoplasm of the liver, either a biliary cystic adenoma or a biliary cystic adenocarcinoma.

[0:45.8]  

Now in this case, this turned out to be a benign biliary cystic adenoma. 

[0:49.5]  

But just based on the imaging appearance, I don't think it's possible to really make that distinction accurately. 

[0:54.7]  

Now these tumors can be very difficult to deal with for surgeons.

[0:58.0]  

Often there are trouble getting complete surgical margins, and in my experience these tumors often will reoccur at the surgical margin. 

[1:05.2]  

But I think in general, anytime you see a complicated cystic mass in the liver, patient doesn't have an underlying history of malignancy elsewhere, and you see nodularity and thick septations, you have to raise the possibility of this diagnosis.

[/d]    

（解说词整理：张隐笛 杨敏洁）